TV shows and movies love to joke about having sex during pregnancy – especially about what could happen to the baby. Seth Rogen’s character in Knocked Up is worried about poking his unborn baby in the face, while Sarah Jessica Parker’s character in Sex and the City jokes that that’s where dimples come from.

While these concerns are comical when expressed by fictional characters, they are also concerns that people have in real life. In fact, research shows that about half of women report fears that sexual activity could harm their baby or cause serious complications to their pregnancy (like bleeding, preterm labour, or miscarriage) [1-3]. These fears are found across cultures and may even lead women to stop engaging in sexual activity while pregnant [4-8].

Are these concerns and fears about sex harming the pregnancy warranted? Should women be refraining from sex during pregnancy in order to avoid harm to their pregnancy?

Research tells us that, for low risk pregnancies (pregnancies without complications such as lower genital tract infection or placenta previa), sex is safe and may even have some benefits during pregnancy [9,10]*. This means that, for the majority of women, sex will not harm the pregnancy and so avoiding sex due to fear of harming the pregnancy is not necessary. That’s good news! However, women still report not engaging in sexual activity during pregnancy due to these fears and past research does not tell us is whether women who avoid sex due to fear of harming their pregnancy experience lower sexual and relationship well-being.

This is what we wanted to know. Specifically, we wanted to (1) describe the importance of fears of sexual activity harming the pregnancy in women’s decision not to have sex during pregnancy and (2) examine how these fear-based reasons for not engaging in sexual activity relate to women’s sexual functioning, sexual satisfaction, sexual distress, and relationship satisfaction during pregnancy.

What did we do?

We had 261 women complete an online survey that included validated measures of sexual functioning, sexual satisfaction, sexual distress and relationship satisfaction. We also asked women to think back on times they chose not to engage in sexual activity (defined as genital stimulation, oral sex, vaginal intercourse, and/or anal intercourse) in the last month and rate how important fears of complicating the pregnancy or harming the baby were in this decision. Fears were rated on a scale of 1 (not important at all) to 7 (extremely important) and included concerns about preterm labour, bleeding, infection, and harming or injuring the baby. Women were asked about their own fears as well as their partner’s fears.

What did we find?

Overall, we found that 58.6% of women endorsed (rated the fear above 1 [not at all important]) at least one fear as a reason for not engaging in sexual activity in the past month, but women’s average fear scores were low (average = 1.7 out of a possible 7).

We also found that women who reported more fear-based reasons for not engaging in sexual activity were more likely to experience greater sexual distress (negative feelings related to their sexuality and/or sexual relationship).

We did not find a link between women’s fear-based reasons for not engaging in sexual activity and their sexual functioning, sexual satisfaction, or relationship satisfaction.

What do these findings mean?

Broadly, this research tells us that if you have been pregnant, chances are that you felt at least a little concerned about being sexually active during your pregnancy, but that these concerns did not have a big impact on your overall sexual and romantic relationship.

Overall fear scores were low, and over 40% of women did not report any fear-based reasons. This means that most pregnant women do not rate fears as overly important in their decision not to engage in sexual activity during pregnancy.

When women do experience these fears they may be more likely to feel distressed about their sexual relationship. This includes feelings of guilt, frustration, unhappiness, and inadequacy. It is possible that women who are concerned about sex harming their pregnancy also pay more attention to the sexual changes that are common during pregnancy, such as reduced desire and changes in body image. In turn, this might lead to more distress and worry about their sexual relationship in general.

Conclusion

Taken together, our results suggest that fears of sexual activity harming the pregnancy are not a strong predictor of women’s overall sexual and relationship well-being during pregnancy. As such, interventions that focus specifically on women’s fears of sexual activity may not be necessary for most women, and may not be essential for promoting women’s broader sexual and relationship well-being during pregnancy. Instead, interventions that focus on other areas of women’s sexuality and relationship, such as normalizing changes in women’s sexual functioning or finding alternative and enjoyable sexual positions, may be more valuable. Still, interventions focused on minimizing fears related to sexual activity may help to reduce women’s global feelings of worry and anxiety about their sexual relationship during pregnancy.

* Note: Please talk to your doctor if you have any concerns about having sex while pregnant.